Fig. 3

Patellar bone position (PBP) grading (a): the dual-cerclage-augmentation technique (DCA) shows a significantly improved distalization of the patella bone position compared to transplant without any cerclage (NCA) or a simple cerclage without a transosseous patella fixation (TFSC). Even though the TFSC technique had better stabilization than NCA, the differences were still significant to the normal, contralateral values. b The measured patello-tibial distance (PTD) was comparable to the contralateral tendon, resembling a sufficient counterforce to the quadriceps muscle, whereas the NCA and TFSC groups were significantly elongated. (One-way ANOVA, rods indicating significant differences with p < 0.0001)